| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | HARVARD PILGRIM HEALTH CARE | $50K | $0 | $50K | 1.83% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | $5K | $0 | $5K | 3.37% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | STANDARD INSURANCE COMPANY | $8K | $713 | $9K | 9.23% |
| ASSUREDPARTNERS3 Filed as: JENNIFER A. BORISLOW AGENCY INC | ONE GRIFFIN BROOK DRIVE METHUEN, MA 01844 | VISION SERVICE PLAN | $971 | $0 | $971 | 10.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 282 | $2.7M |
| Dental | DELTA DENTAL OF MASSACHUSETTS, INC. DBA DELTA DENTAL OF MA | 271 | $142K |
| Vision | VISION SERVICE PLAN | 48 | $10K |
| Life insurance | STANDARD INSURANCE COMPANY | 109 | $99K |
| Long-term disability | STANDARD INSURANCE COMPANY | 109 | $99K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 282 | $2.7M |
| Other | STANDARD INSURANCE COMPANY | 109 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.